Standard institutional practice typically requires the top of a medical valve (or other medical device IV access ports) to be cleaned/swabbed prior to each access, such as prior to insertion of a syringe into the medical valve. The proper technique for cleaning medical device access ports requires attention, diligence and a small amount of time. It is critical that the access port is properly cleaned prior to each access. If the access port is not properly cleaned, microbes may be pushed into the medical device and enter the blood stream, which may cause serious infection (e.g., Catheter Related Blood Stream Infections or “CRBSI”).
Several factors may lead to a medical device access port not being properly cleaned or protected. In many cases, the swabbing technique is inadequate due to lack of awareness. In other cases the access port top geometry contains features that trap debris and microbes that inhibit adequate cleaning and removal. Additionally, there are instances in which the access port does not get cleaned at all due to the many distractions that may be taking place, haste, or lack of disinfecting supplies available at the instance the medical device is to be used. Furthermore, the medical device may be exposed to debris and microbes for a period of time prior to first use, making cleaning more difficult.
The most common way of cleaning and disinfecting an IV access port is to use a single-use alcohol wipe (70% IPA). These wipes (pads) are commonly found throughout the institution packaged in foil pouches/packets, one per packet. Once removed from the packet, a user may grasp the wipe with their forefinger and thumb and swipe it across the top of the access port.
There are numerous problems associated with this method of cleaning a medical device. First, a single swipe may be insufficient to adequately clean the access port. Additionally, the alcohol wipe may be unable to clean in crevices and grooves in the access port.
Another way of cleaning and disinfecting a medical device is to use a swab cap. As the name suggests, swab caps are caps that may be placed over the medical device and used to swab the access port. Each swab cap may include a swab material pre-loaded with a cleaning agent (e.g. 70% IPA) within the interior of the cap. When the cap is placed over the access port of the medical device housing, the swab material contacts the access port, and the cleaning agent cleans/disinfects the access port. Problems associated with such caps are that they may not be readily available (e.g., the medical staff may not be near the supply of caps when needed), and they are easily lost/misplaced.
Additionally, swab caps do not protect the access port upon the medical device's removal from a primary, sterile package. Furthermore, swab caps are typically not used until after the initial access of the medical device, which may be hours to days after the medical device is removed from the sterile package.